Guide to Health Insurance and Health Care ... - New York City

Guide to

Health Insurance and Health Care Services

for Immigrants in New York City

Photo is of a model used for illustrative purposes only.

WELCOME

New York City is home to vibrant immigrant communities from all corners of the world. All of us?whether long-time residents or new to the City?need access to health care to keep our communities healthy and strong. There are many ways for residents to get affordable health care in our city, regardless of immigration status.

This GUIDE TO HEALTH INSURANCE AND HEALTH CARE SERVICES FOR IMMIGRANTS IN NEW YORK CITY is designed to help you find health insurance options and health care resources for immigrants in New York City. It tells you how to get health insurance and other health care services. Even if you don't have health insurance and need care, you can still get it in NYC. There are a number of coverage and care options available depending on your immigration status.

All New Yorkers are eligible for and are entitled to health care services regardless of their immigration status.

KEY HEALTH INSURANCE TERMS

Obtaining health coverage for many immigrant New Yorkers can be confusing.

Before learning about the various coverage options described in this guide, there are a few key terms that you should know to help you choose the option that best fits your and your family's health care needs.

Health Care ? the prevention or treatment of illness by doctors and other medical professions. Health Insurance ? a way to pay for health care. It protects you from paying the full costs of medical services when you see a doctor. Public Health Insurance ? health insurance plans provided through federal programs such as Medicaid and Medicare as well as state health insurance programs such as Child Health Plus and the Essential Plan for those persons who meet program eligibility requirements. Private Health Insurance ? health insurance plans provided through an employer or union as well as purchased by an individual directly from an insurance company. NY State of Health Marketplace ? The state's official health insurance marketplace, visit nystateofhealth.. You can compare private health insurance options and apply for financial help that could lower the cost of your health coverage. You may also qualify for health insurance coverage such as Medicaid, Child Health or the Essential Plan. In-Person Assistors (Navigators, Certified Application Counselors, Certified Marketplace Facilitated Enrollers) ? individuals who work with community organizations to provide free help for individuals and small businesses to assist them in choosing and signing up for health insurance coverage through the New York State of Health Marketplace.

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HEALTH INSURANCE AND YOUR IMMIGRATION STATUS

Remember, by law all New York City residents have the right to: Equal treatment in health care services no matter where you are from or what language you speak. Hospital treatment if you have a medical emergency, regardless of ability to pay. Free language assistance, if you need it. All health and social service providers must arrange for interpretation in your preferred language. Confidential access to city services and public and private health insurance. Your immigration status will be kept private. When you apply for health insurance, information about your immigration status will be used only to determine eligibility for benefits and not for immigration enforcement. Your immigration status is not reported to the US Immigration and Customs Enforcement (ICE) or US Citizenship and Immigration Services (USCIS).

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TABLE OF CONTENTS

Comprehensive Health Insurance Coverage Covers a range of health services, like doctor visits, hospital care, and prescription drugs

Limited Health Insurance Coverage Covers limited health services, like family planning or emergency care

Free or Lower Cost Health Care Services Ways to get affordable health services, even if you don't have insurance

Pharmacy Assistance and Other Care Services Programs that provide financial assistance and discounts when you go to the pharmacy

Where to Apply for Health Insurance and Get Low-Cost Health Care Where to apply for health insurance

Immigration Terms for Health Insurance Select Immigration categories relating to health insurance eligibility

1 - 2

3

4

5

6

7 - 8

We hope this guide helps you get the coverage and care you need when you need it.

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COMPREHENSIVE HEALTH INSURANCE COVERAGE

PROGRAM MEDICAID

BENEFITS

REQUIREMENTS

Free health insurance for low-income adults & children; can also pay medical bills for care received up to 3 months before application

? NYS resident ? Lower-Income

MEDICAID BUY-IN FOR WORKING PEOPLE WITH DISABILITIES

Free health insurance

? NYS resident ? Moderate to

Lower-Income ? Age: 16-64 ? Working ? Be disabled

ELIGIBLE IMMIGRANTS* WHERE TO GET IT

? Qualified immigrants (No 5 year Ban)

? PRUCOL, including DACA

? All pregnant women, including undocumented women

? Certain temporary residents (e.g. student with valid visa)

For most: NY State of Health

Online: nystateofhealth.

Phone: 1-855-355-5777

In-Person: Call 311 to get help from someone in your community (ask for "navigator" or "enroller")

Some people: NYC Human Resources Medicaid Offices (If 65 and older, or if person living with a disability)

Online: html/hra/html/ services/medicaid_offices. shtml

? Qualified immigrants (No 5 year ban)

? PRUCOL, including DACA

Phone: 1-718-557-1399

NYC Human Resources Administration Medicaid Offices

Online: html/hra/html/ services/medicaid_offices. shtml

Phone: 1-718-557-1399

CHILD HEALTH PLUS (CHP)

Free or lower-cost health insurance for children

? NYS resident ? No income

requirements - Lower-income

families pay nothing - Middle-income families pay a little - Higher-income families can pay full price

? All children under 19, NY State of Health

including undocumented immigrant children

Online: nystateofhealth.

Phone: 1-855-355-5777

In-Person: Call 311 to get help from someone in your community (ask for "navigator" or "enroller")

*Refer to pages 7 - 8 for "Immigration Terms for Health Insurance".

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COMPREHENSIVE HEALTH INSURANCE COVERAGE

PROGRAM ESSENTIAL PLAN

BENEFITS

REQUIREMENTS

Free or low-cost health ? Age: Adults 19-64

insurance for lower- ? NYS resident

income adults

? Lower-income

(people who make

over the Medicaid

limit)

PRIVATE HEALTH INSURANCE (NY STATE OF HEALTH MARKETPLACE)

Choice of health insurance plans; financial help is available

? NYS resident ?For financial help: - Middle-income to low-income - Not eligible for Medicaid or Medicare - No job-based coverage - Income limit

FULL-COST

Health insurance

PRIVATE HEALTH purchased at full price

INSURANCE

directly from an

(OUTSIDE OF THE NY insurance company

STATE OF HEALTH

MARKETPLACE)

MEDICARE

Health insurance for people 65 and over or who have a disability or end-stage renal disease

None

? Residents and their spouses who have worked 10 years or more in the US

? Age: - 65 or older - Any age if have a disability or endstage renal disease

ELIGIBLE IMMIGRANTS* WHERE TO GET IT

? Qualified immigrants (No 5 year ban)

? Most PRUCOL (not DACA) ? Certain temporary residents

(e.g. student with valid visa)

NY State of Health

Online: nystateofhealth.

Phone: 1-855-355-5777

? Lawfully present immigrants, which includes most qualified immigrants and most PRUCOLs (not DACA)

? All immigrants, including undocumented immigrants

In-Person: Call 311 to get help from someone in your community (ask for "navigator" or "enroller")

NY State of Health

Online: nystateofhealth.

Phone: 1-855-355-5777

In-Person: Call 311 to get help from someone in your community (ask for "navigator" or "enroller")

Directly from insurance company

? Qualified immigrants

Social Security Administration (SSA) Offices

Online: medicare/apply.html

Phone: 1-800-772-1213

In-Person: Visit your local Social Security office.

Get help: Call 311 to get help from a Health Insurance Information Counseling and Assistance (HIICAP) program counselor

*Refer to pages 7 - 8 for "Immigration Terms for Health Insurance".

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LIMITED HEALTH INSURANCE COVERAGE

PROGRAM

BENEFITS

REQUIREMENTS

ELIGIBLE IMMIGRANTS* WHERE TO GET IT

MEDICAID FOR

Helps eligible

THE TREATMENT undocumented and

OF AN EMERGENCY temporary immigrant

MEDICAL

New Yorkers pay for

CONDITION

medical costs when they

(ALSO KNOWN

have an emergency

AS EMERGENCY

MEDICAID)

Note: All hospitals

must treat you if

you have a medical

emergency,

regardless of your

ability to pay

? NYS residency (temporary lawful residents do not have to meet the State residency requirement)

? Low-income

? Undocumented and temporary immigrants without NYS residency (e.g. tourists).

Note: Undocumented pregnant women may be eligible for Medicaid and all undocumented children are eligible for Child Health Plus See page 1

Most people: NY State of Health

Online: nystateofhealth.

Phone: 1-855-355-5777

In-Person: Call 311 to get help from someone in your community (ask for "navigator" or "enroller")

Some people: NYC Human Resources Medicaid Offices (If 65 and older, or if person with a disability)

Online: html/hra/html/services/ medicaid_offices.shtml

FAMILY PLANNING BENEFIT PROGRAM (FPBP)

Provides free and confidential reproductive health services

? NYS resident ? Moderate or

lower-income ? No Medicaid ? Can have Child

Health Plus or private insurance

? Qualified immigrants ? PRUCOLs, including

DACA

Phone: 1-718-557-1399 Approved FPBP Provider

Online: famplan

Phone: 1-800-541-2831

FAMILY PLANNING EXTENSION PROGRAM (FPEP)

MEDICARE SAVINGS PROGRAM

Pays for birth control ? NYS resident and reproductive health ? Have no other services after pregnancy insurance

Helps pay for Medicare ? NYS resident

premiums, coinsurance, ? Low-income

and deductibles

? Have Medicare

? Undocumented immigrants

Automatic enrollment after pregnancy ends if already enrolled in Medicaid

? Qualified immigrants, (No NYC Human Resources

5 year ban)

Administration Medicaid Offices

? PRUCOL, including DACA

Online: site/hra/locations/medicaid-loca-

tions.page

Phone: 1-718-557-1399

*Refer to pages 7 - 8 for "Immigration Terms for Health Insurance".

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FREE OR LOWER COST HEALTH CARE SERVICES

PROGRAM

BENEFITS

REQUIREMENTS ELIGIBLE IMMIGRANTS* WHERE TO GET IT

HHC OPTIONS

FEDERALLY QUALIFIED HEALTH CENTERS (FQHCs)/ COMMUNITY CLINICS

Lower costs for all services ? No other insurance provided at NYC Health + ? Moderate or lowerHospitals facilities, which income (sliding scale may include hospital stays, fee based on income emergency and clinic visits and family size)

Lower costs for all services provided at the health center, which may include primary care, vision, dental and mental health services

? No other insurance ? Moderate or

lower-income (sliding scale fee based on income and family size)

? All immigrants, including undocumented immigrants

At a NYC Health Hospitals facility

To find a facility near you, visit: hhc

? All immigrants, including At health center, after undocumented immigrants receiving care

To find a health center near you, visit:

NYC HEALTH DEPARTMENT CLINICS

Provides immunizations, None STD testing and TB testing at low-cost

HOSPITAL FINANCIAL ASSISTANCE/ CHARITY CARE

AIDS DRUG ASSISTANCE PROGRAM (ADAP)

Lower costs for hospital stays, emergency and clinic visits at all hospitals in NY

? NYS resident ? No other insurance ? Moderate or

lower-income (sliding scale fee based on income)

Helps pay for

? NYS resident

medications, primary ? Clinically

care, and home care symptomatic HIV

for people with HIV/

or AIDS diagnosis

AIDS. Also helps pay ? Middle-income to

private health

low-income

insurance premiums and ? No Medicaid

copays

? All immigrants, including undocumented immigrants

? All immigrants, including undocumented immigrants

At NYC Health Department clinics

To find a NYC Health Department clinic near you, visit: health or call 311

At hospital, after receiving care

? All immigrants, including undocumented immigrants

NYS Department of Health

For more information, visit health.diseases/aids/ general/resources/adap/ eligibility.htm or call 1-800-542-2437

*Refer to pages 7 - 8 for "Immigration Terms for Health Insurance".

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